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解决微生物学实验室和临床单位之间的主要沟通障碍:一项定性研究。

Addressing the key communication barriers between microbiology laboratories and clinical units: a qualitative study.

机构信息

Norwegian Advisory Unit for Antibiotic Use in Hospitals, Department of Research and Development, Haukeland University Hospital, 5021 Bergen, Norway.

Department of Health Studies, University of Stavanger, 4036 Stavanger, Norway.

出版信息

J Antimicrob Chemother. 2017 Sep 1;72(9):2666-2672. doi: 10.1093/jac/dkx163.

Abstract

BACKGROUND

Many countries are on the brink of establishing antibiotic stewardship programmes in hospitals nationwide. In a previous study we found that communication between microbiology laboratories and clinical units is a barrier to implementing efficient antibiotic stewardship programmes in Norway. We have now addressed the key communication barriers between microbiology laboratories and clinical units from a laboratory point of view.

METHODS

Qualitative semi-structured interviews were conducted with 18 employees (managers, doctors and technicians) from six diverse Norwegian microbiological laboratories, representing all four regional health authorities. Interviews were recorded and transcribed verbatim. Thematic analysis was applied, identifying emergent themes, subthemes and corresponding descriptions.

RESULTS

The main barrier to communication is disruption involving specimen logistics, information on request forms, verbal reporting of test results and information transfer between poorly integrated IT systems. Furthermore, communication is challenged by lack of insight into each other's area of expertise and limited provision of laboratory services, leading to prolonged turnaround time, limited advisory services and restricted opening hours.

CONCLUSIONS

Communication between microbiology laboratories and clinical units can be improved by a review of testing processes, educational programmes to increase insights into the other's area of expertise, an evaluation of work tasks and expansion of rapid and point-of-care test services. Antibiotic stewardship programmes may serve as a valuable framework to establish these measures.

摘要

背景

许多国家都即将在全国的医院建立抗生素管理计划。在之前的研究中,我们发现微生物实验室与临床科室之间的沟通是在挪威实施高效抗生素管理计划的障碍。我们现在从实验室的角度解决了微生物实验室与临床科室之间的主要沟通障碍。

方法

对来自六个不同的挪威微生物实验室的 18 名员工(经理、医生和技术人员)进行了定性半结构式访谈,代表了所有四个地区卫生当局。对访谈进行了录音和逐字转录。应用主题分析,确定了新兴主题、子主题和相应描述。

结果

沟通的主要障碍是标本物流、请求表上的信息、口头报告检测结果以及在集成度差的 IT 系统之间的信息传输中断。此外,由于彼此缺乏专业知识的深入了解以及实验室服务的有限提供,导致周转时间延长、咨询服务有限和开放时间受限,这也对沟通造成了挑战。

结论

通过审查检测流程、增加对彼此专业领域的了解的教育计划、评估工作任务以及扩大快速和床边检测服务,可以改善微生物实验室与临床科室之间的沟通。抗生素管理计划可以作为建立这些措施的有价值的框架。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c875/5890706/04033f1fe05c/dkx163f1.jpg

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